title: Supratentorial gross-totally resected non-anaplastic ependymoma: population based patterns of care and outcomes analysis.
abstract: Observation following gross-total resection (GTR) for non-anaplastic supratentorial ependymomas is often advocated based on small, retrospective series. The purpose of this study is to perform a population-based analysis to examine outcomes for this rare cohort of low-risk patients. A retrospective analysis was conducted utilizing the Surveillance, Epidemiology and End Results Program of the United States National Cancer Institute. We identified patients with supratentorial non-anaplastic ependymoma who underwent GTR alone or GTR followed by radiation. We identified 92 patients who met these criteria. The median age was 17.5 years (range 1-83) with the majority female (58 %) and white (75 %). Radiotherapy (RT) was delivered in half of patients. The 5-/10-year Kaplan-Meier estimated overall survival (OS) and cause-specific survival (CSS) for the overall cohort was 83.2/71.4 and 84.1/78.0 %, respectively. There was no evidence of decreased CSS (HR 0.52 [0.18-1.51]; p = 0.23) or OS (HR 0.63 [0.25-1.59]; p = 0.33) with the omission of RT on univariate analysis. Age ≥18 years correlated with worse OS (HR 4.01 [1.45-11.11]; p = 0.008) and CSS (HR 2.86 [0.99-8.31]; p = 0.05). RT did not impact outcome for this low-risk cohort of patients. Older age correlates with poor prognosis.
authors.affiliation: Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Unit 0097, Houston, TX, 77030, USA, ajghia@mdanderson.org.
authors.forename: Amol J
authors.initials: AJ
authors.lastname: Ghia
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Allen
authors.forename: Terri S
authors.initials: TS
authors.lastname: Armstrong
authors.forename: Frederick F
authors.initials: FF
authors.lastname: Lang
authors.forename: Mark R
authors.initials: MR
authors.lastname: Gilbert
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D055815:Young Adult